11 February 2018

Government stalls on supplies of drugs as death toll rises

Media reports from around Papua New Guinea have drawn attention to the critical shortages of vital medicines in hospitals, health centres and aid posts.

These shortages are causing unnecessary suffering and even death – especially among the most vulnerable; young children, pregnant mothers, the elderly and disabled.

All of which could be prevented.

PNGi has discovered that the government has to hand a detailed report setting out solutions that would tackle critical failings observed within the National Department of Health and its private contractors; yet is failing to implement the recommended reforms.

The report, dated 6 November 2017, which is sitting on the Health Minister’s desk, is from a wide ranging ‘special’ audit, ordered by the Prime Minister, coordinated by the Chief Secretary and conducted by the Internal Audit Branch of the Prime Minister’s Department.

The, auditors damning findings, reveal widespread failures throughout the medical supply and distribution chain which, they claim, have persisted and not been addressed over several years.

The report contains details on a specific instance of alleged high-level corruption, widespread opportunities for fraud, overpayments to contractors totalling as much as K80 million a year, and delays in orders and distribution which can last not just months but years.

It also reveals widespread violation of proper management and accounting principles within the Health Department and a complete failure to monitor the performance of companies on multi-million kina contracts.

The audit report recommends a number of immediate, short-term and long-term reforms to deal with the most critical failures, including the outsourcing of the procurement function away from Health Department in order to address the “urgent need to have an effective and efficient procurement and distribution of medical supply system”.

Comments

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The PNG media indeed appear hamstrung and muzzled. That is the crux of the matter. PNG Attitude and other blogs stand as independent but limited reflections of what is really happening.

Clearly Chris is right. The editors and owners of the media are obviously in cahoots with the political leaders else the political leaders wouldn't dare show their faces or turn up to collect their pay.

For many years I was on the board of Mt Hagen Hospital and then on the Western Highlands Health Board.

Staff and board members both endeavoured to have all the equipment needed, and to have an adequate supply of drugs. But it was a struggle.

If I remember correctly at one stage we had difficulty in importing a treadmill for the heart-clinic because customs wanted to insist the treadmill was “sporting equipment” and should be taxed accordingly.

Some local clans were also very generous in footing the cost of some of the medical items for the heart-clinic.

Lindsay Cheers, an adviser who came from South Australia, was very successful in helping to bring needed change and at the same time was very diplomatic about it all. But the efficient supply of drugs has continued to be an ongoing problem.

It is probably no consolation, but the media in UK and Ireland are continually highlighting the inadequacies of the health systems. Seriously ill patients often have to wait days on trolleys as there are insufficient beds in many hospitals.

On the positive side in WHP, there were a great number of very committed staff trying their best with at times inadequate resources. The drug supply system can and must be improved.

It is a shameful situation for those of us with any conscience at all for the welfare of the people, and rightly a national disgrace to all governments since independence who have let the health system down, time and again.

And the answers, if I may add, are staring at us in PNG glaringly in the face!

The real travesty as Chris points out is that Kiaps with the help of the RPNGC able to achieve what apparently today is impossible. Likewise, much the same applies in other disciplines during the Australian administration.

The problem appears to be a mind set that wasn't able to be passed on when we left. Clearly that mind set was not allowed to be successfully fostered and grown.

The reason why this happened is now clear. Politicians on both sides of the Torres Straight had really no idea of how the Kiap system of rural administration actually worked and had no intention or interest in finding out.

It's like looking at a beautiful painting and then setting out to paint the same painting without being taught how to? When the result is unsatisfactory, then denigrating the original painter by suggesting times have changed whereas people haven't.

About 20 years ago I was the Chief Executive of a large regional hospital at Mount Gambier in South Australia.

At that time, two of my colleagues left SA Health and took up appointments as advisers to the Lae and Mount Hagen hospitals respectively.

They soon realised that the health system in PNG was in a parlous state. They contacted me and asked me to "twin" my hospital with the Mendi hospital and provide it with help and support.

To this end, I persuaded my Board of Directors to allow me to visit Mendi hospital in early 1999.

I was greeted at Mendi by the hospital's Manager, who took me on a tour of the facility. It was in a terrible state, being desperately short of equipment, drugs and all the essential materials required to provide a decent service to the local people.

The staff, notably the nurses, were working miracles with almost nothing. I was amazed at their ability to do this. They were incredibly committed and had good skills but utterly unsupported.

All but one piece of biomedical equipment in the hospital was unserviceable, mostly because no spares were available for the competent bio-medical technician to repair or maintain the equipment. Appeals to Port Moresby for help had fallen on deaf ears.

Upon my return to Mount Gambier I asked my senior bio-medical technician, a man with exceptional skills as an instrument maker and miniature engineer, if he would go to Mendi to help repair the bio-medical equipment. He agreed.

I asked him to call in every favour ever owed to us by the manufacturers and retailers of bio-medical equipment used by the hospital. Also, I asked him to contact every colleague in SA to try to source whatever obsolete, redundant or spare piece of equipment he could lay his hands on.

He subsequently spent 6 weeks in Mendi during which time, with access to two huge crates of equipment sent from Mount Gambier, he and the local technician repaired every piece of equipment in the hospital. This was very well received.

I also organised a staff exchange, whereby two senior nurses from Mendi came to Mount Gambier for 6 weeks to learn as much as they could about how we did things, especially in relation of accident and emergency services. We organised local accommodation and meals for them, while Mendi paid their airfares.

Unhappily, I was unable to maintain the relationship because my Board bulked at the costs involved. We were under tremendous budget pressure then and they felt that we could not (politically) justify spending many thousands of dollars on a remote hospital in PNG.

Rather more happily, my senior bio-medical technician's efforts had not gone unnoticed by AusAid. They paid for him to spend about 3 months each year travelling around the Pacific fixing stuff. I cannot recall how long he did this for, but it was several years at least.

Now, 20 years later, nothing much seems to have changed. A former colleague is now in Mount Hagen and he believes that most hospital staff are doing their best with little or no support from a government which is either unwilling or unable to support them.

The PNG government is a disgrace to its nation. It routinely betrays its people through incompetence or corruption or indifference.

It is beyond belief that the desperately under resourced colonial administration was more able to deliver basic health, education and transport services than the PNG government has shown itself over the past several decades.

The same can be said for the maintenance of law and order. A mere handful of Patrol Officers and members of the RPNGC carried out this task, mostly without resort to heavy handed tactics or violence.

It wasn't perfect, but it did work, mainly because the people accepted that they received fair treatment most of the time, even if they didn't like the outcomes that much.

Surely there is someone, somewhere, whether in the government or in the ranks of the PNG public service who can do something about this deplorable state of affairs?

It is not hard to foresee a very grim future for PNG if the current state of affairs is allowed to persist.

This is painful to contemplate for those of us lapuns who once believed that the country could and should have a shining future.